DESCRIPTION: This research project will test hypotheses about the effects of otitis media (middle ear effusion) on young children's language, attention, and social behavior. Based on the findings from the previous grant, a Cumulative Risk Model will be tested to determine the influence of risk/protective factors (moderators) on whether otitis media and the accompanying hearing loss has negative outcomes for 200 children followed from infancy to 3 years of age in daycare. Environmental influences in the home and in the daycare will be measured carefully to understand whether these environments buffer children against the negative effects of otitis media or actually exacerbate them.